Program of All-Inclusive Care for the Elderly

Wood carvings of variety of animals provide a unique backdrop for a bike trail in Hudson/Photo by Douglas Flynn

The Program of All-Inclusive Care (PACE) provides comprehensive long-term services and supports to Medicaid and Medicare enrollees.

It is designed to provide community-based services to people age 55 or older who otherwise would need a nursing home level of care.

A team of health professionals assesses an enrollee’s needs, develops care plans and delivers all services to the enrollee. That team can consist of primary care physicians, nurses, social workers, physical therapists, recreational therapists, dietitians, PACE center supervisors and personal care attendants.

PACE benefits include all Medicaid and Medicare covered services, such as:

• Primary care
• Hospital care
• Medical specialty services
• Prescription drugs
• Nursing home care
• Emergency services
• Home care
• Physical therapy
• Occupational therapy
• Adult day care
• Recreational therapy
• Meals
• Dentistry
• Nutritional counseling
• Social services
• Laboratory and X-ray services
• Social work counseling
• Transportation

What caregivers need to know

If your care recipient is interested in enrolling in a PACE program, here is some important information to consider:

• Individuals can join PACE if they are: age 55 or older; live in the service area of a PACE organization; are eligible for nursing home care; and are able to live safely in the community
• The PACE program becomes the sole source of services for Medicare and Medicaid eligible enrollees.
• Individuals can leave the program at any time.
• If you have Medicaid/MassHealth, you will not pay a monthly premium for the long-term care portion of the PACE benefit. If you do not qualify for Medicaid/MassHealth but have Medicare, you will be charged a monthly premium to cover the long-term care portion of the PACE benefit and a premium for Medicare Part D drugs. There is no deductible or co-payment for any drug, service or care approved by your health care team. If you do not have Medicare or Medicaid/MassHealth, you can pay for PACE privately.
• In 2014, MassHealth income and asset rules for PACE were an income level no greater than $2,163 per month, which is three times the federal SSI benefit amount ($721 per month for 2014), and countable assets no greater than $2,000. If married, your spouse’s income and assets are not counted. There are no fees for the program if you have MassHealth. If you do not have MassHealth, you may have to pay a monthly premium.
• PACE covers prescription drugs. If you join a PACE program, you will get Medicare Part D covered drugs and other necessary medication from the PACE program.
• To be eligible for PACE, a person must live in the service area of a PACE organization. Not all towns in MetroWest are covered by a PACE organization, but Summit ElderCare in Worcester does serve the following MetroWest communities: Hopedale, Hudson, Marlborough, Mendon, Milford, Northborough, Southborough, Westborough
  
  

  Summit ElderCare
  Address: 10 Chestnut Street
  Worcester, MA 01608
  Phone: 1-800-698-7566
  Website: http://www.summiteldercare.org/

• Click here, for a full list of Massachusetts Pace Services Areas, provided by mass.gov

Related information and additional web resources

General information about the PACE program can be found on both the Medicaid  and Medicare websites.

There is also a quick facts brochure [PDF] about PACE available through the Center for Medicare & Medicaid Services.